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Objective:To investigate the clinical features and prognosis of male with anti-melanoma differentiation-associated gene 5 (MDA5) autoantibody.Methods:The clinical data of 246 patients with DM and anti-MDA5 autoantibodies hospitalized by Jiangsu Myositis Cooperation Group from 2017 to 2020 were collected and retrospectively analyzed. Chi-square test was performed to compared between counting data groups; Quantitative data were expressed by M ( Q1, Q3), and rank sum test was used for comparison between groups; Single factor survival analysis was performed by Kaplan-Meier method and Log rank test; Cox regression analysis were used for multivariate survival analysis. Results:①The male group had a higher proportion of rash at the sun exposure area [67.1%(47/70) vs 52.8%(93/176), χ2=4.18, P=0.041] and V-sign [50.0%(35/70) vs 30.7%(54/176), χ2=8.09, P=0.004] than the female group. The male group had higher levels of creatine kinase [112(18, 981)U/L vs 57 (13.6, 1 433)U/L, Z=-3.50, P<0.001] and ferritin [1 500 (166, 32 716)ng/ml vs 569 (18, 14 839)ng/ml, Z=-5.85, P<0.001] than the female group. The proportion of ILD [40.0%(28/70) vs 59.7%(105/176), χ2=7.82, P=0.020] patients and the red blood cell sedimentation rate[31.0(4.0, 101.5)mm/1 h vs 43.4(5.0, 126.5)mm/1 h, Z=-2.22, P=0.026] in the male group was lower than that of the female group, but the proportion of rapidly progressive interstitial lung disease (PR-ILD) [47.1%(33/70) vs 31.3%(55/176), χ2=5.51, P=0.019] was higher than that of the female group. ②In male patients with positive anti-MDA5 antibodies,the death group had a shorter course of disease[1.0(1.0, 3.0) month vs 2.5(0.5,84) month, Z=-3.07, P=0.002], the incidence of arthritis [16.7%(4/24) vs 42.2%(19/45), χ2=4.60, P=0.032] were low than those in survival group,while aspartate aminotransferase (AST)[64(22.1, 565)U/L vs 51(14,601)U/L, Z=-2.42, P=0.016], lactate dehydrogenase (LDH) [485(24,1 464)U/L vs 352(170, 1 213)U/L, Z=-3.38, P=0.001], C-reactive protein (CRP) [11.6(2.9, 61.7) mg/L vs 4.95(0.6, 86.4) mg/L, Z=-1.96, P=0.050], and ferritin levels [2 000(681, 7 676) vs 1 125 (166, 32 716)ng/ml, Z=-3.18, P=0.001] were higher than those in the survival group, and RP-ILD [95.8%(23/24) vs 22.2%(10/45), χ2=33.99, P<0.001] occurred at a significantly higher rate. ③Cox regression analysis indicated that the course of disease LDH level, and RP-ILD were related factors for the prognosis of male anti-MDA5 antibodies [ HR (95% CI)=0.203(0.077, 0.534), P=0.001; HR (95% CI)=1.002(1.001, 1.004), P=0.003; HR (95% CI)=95.674 (10.872, 841.904), P<0.001]. Conclusion:The clinical manifestations of male anti-MDA5 antibody-positive patients are different from those of female. The incidence of ILD is low, but the proportion of PR-ILD is high. The course of disease, serum LDH level, and RP-ILD are prognostic factors of male anti-MDA5 antibody-positive patients.
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Objective To explore effects of fosinopril and losartan on renal Klotho expression and oxidative stress in spontaneously hypertensive rats (SHR) and the mechanisms underlying the protection against renal damage. Methods Fifteen male SHRs (22 weeks old) were randomly divided into 3 groups (n=5 in each group): a SHR group, a fosinopril group [10 mg/(kg?d)], and a losartan group [50 mg/(kg?d)]. Age-matched Wistar-Kyoto (WKY) rats were chosen for a control group. Eight weeks later, tail arterial pressure, 24 hours urinary protein (Upro),urinary N-acetyl-β-D-glucosaminidase (NAGase) were measured. Renal pathological changes were examined under light microscopy by HE staining. The renal mRNA and protein expression of Klotho were determined by RT-PCR, immunohistochemical staining or Western blot. The levels of total antioxidant capacity (TAOC), malondialdehyde (MDA), Cu/Zn superoxide dismutase (Cu/Zn-SOD), Mn superoxide dismutase (Mn-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were determined.Results The typical pathological characteristics of hypertensive renal damage were observed in the kidney of the SHR group.Compared with the SHR group, the systolic pressure, Upro, and urinary NAGase, the content of MDA and renal pathological damage was reduced while the renal Klotho expression and activities of TAOC, Cu/Zn-SOD, CAT, and GSH-Px were increased (P<0.05 or P<0.01) in the fosinopril or losartan group. There was no significant difference in renal Mn-SOD level among the 4 groups (P>0.05). Conclusion Fosinopril and losartan can exert protection against hypertensive renal damage through upregulating Klotho expression as well as reducing oxidative stress.
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Objective To investigate the effect of high glucose and losartan on cell proliferation and cyelooxygenase-2 (COX2) expression in normal human mesangial cells (NHMCs), and to examine the effect of losartan on COX2 and transforming growth factor-betal (TGF-β1) expression in a model of diabetic nephropathy (DN). Methods NHMCs were cultured in vitro in high glucose media with or without losartan. NHMCs proliferation and COX2 expression were determined by WST-1, Western blot,and RT-PCR. The rat model of DN was produced by injections of streptozocin (STZ). After the treatment with losartan for 4 weeks, glomerular hypertrophy, urinary thromboxane B2(TXB2) and 24 h urinary pro-tein counts were measured,and COX2 and TGF-β1 expressions were investigated using immunohistochem-ical techniques and RT-PCR. Results Losartan dose-dependently inhibited the proliferation of NHMCs in response to high glucose. Losartan also decreased COX2 expression in NHMCs at high or low glucose concentrations. In vivo experiments found kidney weight/body weight (KW/BW), urinary TXB2 and 24 hurinary protein counts increased significantly in the DN group. Losartan reduced KW/BW, urinary TXB2,and 24 h urinary protein counts and significantly suppressed the over-expression of COX2 and TGF-β1.Conclusion Losartan reduces COX2 expression in NHMCs, especially at high glucose concentrations.Losartan could suppress the expression of COX2 and TGF-β1 in the kidney of DN rats and attenuate the renal lesions caused by DN.
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BACKGROUND: Previous studies have demonstrated that Candida albicans possesses capsule structure. Whether capsule structure is associated with the virulence of Candida albicans?OBJECTIVE: This study investigated the pathogenic difference between the standard strains of Candida albicans and the clinically isolated strains, verified whether capsule was the virulence factor of the Candida albicans, and analyzed the association between the animal pathogenicity of different strains and capsule thickness.DESIGN: A randomized controlled animal experiment.SETTING: Department of Pathogenic Biology, Gannan Medical College.MATERIALS: This study was performed at the Scientific Research Center, Gannan Medical College between May and June 2005. A total of 120 BALB/c mice and 72 healthy adult rabbits were included. Candida albicans strains (CCCMC1a and ATCC 14053) were used. The isolated and cultured 4 strains were numbered as C1-1, C1-2, C1-3,and C1-4.METHODS: All animals were randomly divided into 6 groups with 20 mice and 12 rabbits in each group, namely,CCCMC1a, ATCC 14053, C1-1, C1-2, C1-3, and C1-4 groups. Strains smeared in sabouraud ager medium for 36 hours were diluted into the bacterial solution with physiological saline. This solution was intravenously injected into rabbit ear edge, 1.5 mL per rabbit, and intraperitoneally injected into BALB/c mice, 0.5 mL per mouse. Six hours after administration, animal response was observed, and attack time, death time, and mortality were recorded.MAIN OUTCOME MEASURES: Rabbit nephridial tissue printing slices and mouse peritoneal fluid smears were made for Hiss capsule staining microscopy. The capsule thickness of 40 randomly selected yeast cells in each strain was measured using a microscope-micrometer, and the mean capsule thickness of each strain was compared.RESULTS: Compared with C1-1, C1-3, CCCMC1a, and ATCC 14053, C1-2 and C1-4 possessed stronger animal pathogenicity. The standard strains and clinically isolated strains could form capsule in the rabbit and mouse bodies. Capsule thickness differed due to different strains and animal genera (P < 0.05-0.01). The bacterial capsule thickness was greater in the rabbit renal infection focus than in the mouse abdominal cavity. The bacterial capsule thickness of rabbit renal infection focus and mouse abdominal cavity in the C1-1, C1-2, C1-3, and C1-4 groups was greater than that of the same genus in the CCCMC1a and ATCC 14053 groups. The bacterial capsule thickness of rabbit renal infection focus and mouse abdominal cavity was the greatest in the C1-2 and C1-4 groups.CONCLUSION: Candida atbicans C1-2 and C1-4 strains have strong animal pathogenicity. C1-2 and C1-4 strains possess greater bacterial thickness than other strains. It has been primarily confirmed that capsule is possibly a virulence factor of Candida albicans, and capsule thickness is closely associated with animal pathogenicity.
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BACKGROUND: Studies have confirmed that there is secreted protein out of cell wall of Candida albicans. However, in recent researches, we found there may be a capsule-like-structure within it.OBJECTIVE: To observe the capsule-like structure of Candida albicans by means of modified quellung test.DESIGN: A controlled observation experiment.SETTING: Department of Medical Microbiology, Gannan Medical College.MATERIALS: Candida albicans from 2 clinical specimens (C1, C2) identified by preserve center of Epiphyte strains of Chinese Academy of Science (Nanjing, China) and standard strains (CCCMC1a and ATCC14053) donated by preserve center of Epiphyte strains of Peking University (Beijing, China) were taken to quellung test. Experimental rabbits (weighing 2-2.5 kg) for preparing normal serum and antiserum were donated by Experimental Animal Center of Sun Yat-sen University. Antiserum was prepared by the book with experimental strains (C1, C2, CCCMC1a, and ATCC)respectively for later quellung tests.METHODS: This experiment was carried out in the Department of Medical Microbiology, Gannan Medical College in December 2005. ① Traditional Quellung test: The culture of Candida albicans (C1, C2, CCCMC1a, and ATCC) was spread on a slide respectively. Corresponding rabbit antiserum was added onto the slide (experimental group 1) and normal serum was added onto the slide (control group1). 1% methylene blue was added into each group, and then the slides were placed in a wet box at 37 ℃ for 20 minutes; the slides were taken out and covered with a cover-slip. Under the oil immersion, the count of Candida albicans was taken and the microscopic surveying instrument was used to measure the capsule thickness of cell of Candida albicans directly. The average thickness of capsule of 40 cells was taken. ②Modified quellung test: The culture of Candida albicans (C1, C2, CCCMC1a, and ATCC) was spread on a slide respectively. Corresponding rabbit antiserum was added onto the slide (experimental group 2) and normal serum was added onto the slide (control group 2), 1% methylene blue was not added into each group, but the slides were directly placed in a wet box et 37 ℃ for 20 minutes. The slides were taken out and dried naturally, but not covered with a cover-slip during the drying process. Hiss capsule staining was applied for them.The average thickness of capsule of 40 cells was taken.MAIN OUTCOME MEASURES: The average thickness of capsule in each experimental group in traditional and modified quellung tests.RESULTS: ① Traditional quellung test of Candida albicans was positive. The thickness of culture of Candida albicans C1, C2, CCCMC1a, and ATCC of experimental group1 was larger than that of the control group1, respectively [(0.558+0.081 ) vs. (0.225+0.061) μm; (0.530+0.081) vs. (0.252+0.038) μm; (0.475+0.081) vs. (0.200+0.072) μm;(0.600+0.068) vs. (0.225+0.046) μm,P < 0.01] .② The thickness of culture of Candida albicans C1, C2, CCCMC1a, and ATCC of experimental group 2 was larger than that of the control group 2, respectively[(0.541 ±0.038) vs. (0.215±0.022)μm; (0.510±0.060)vs. (0.247±0.018) μm; (0.487±0.041) vs. (0.213±0.033)μm; (0.595±0.027) vs. (0.220±0.016) μm, P < 0.01]. ③ The thickness of capsule of the control group 2 was smaller than that of control group 1 (P <0.01); The thickness of capsule of the experimental group 2 was smaller than that of experimental group 1 (P < 0.01).CONCLUSION: As a quantitative analysis test, modified quellung test is more stable and accurate than traditional quellung test.
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Objective To observe the renal expression of cyclooxygenase-2(COX-2) in diabetic nephropathy rats and the effects of Losartan as angiotensin II type 1(AT1) receptor antagonist.Methods Twenty-eight diabetic Sprague-Dawley(SD) rats induced with intraperitoneal injection of streptozotocin were randomly divided into two groups: diabetic rats without therapy(group D,n=14) and diabetic rats treated with Losartan(group L,n=14).Twenty SD rats were used as the control(group N).The urine and blood samples in 24h were collected after the treatment with Losartan for 10 weeks.The rats were killed and the renal expression of COX-2 was determined with immunohistochemistry.Results Expression of COX-2 in the nephridial tissue and the concentration of urinary thromboxane B_2(TXB_2) in group D were significantly higher than those in group N(P
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Objective To determine the diagnostic value of endoscopic ultrasound-guided cholangiography(EUSGC)with fine needle puncture .Methods Twenty-six patients with obstructive jaundice failed i n previous endoscopic retrograde cholangiopancreatography(ERCP) and magnetic res onance cholangiopancrcatography(MRCP) or have metallic foreign materials in some where of body. By a linear scanning echoendoscopy in conjunction with a 22-gau ge aspiration needle, transduodenal selective cholangiography was attempted.Results Cholangiography was successfully performed in all patie nts (EUSGC success 100% vs. ERCP 0%). No complications occurred in the patients. In 19 patients, abnormalities were found from EUSGC. Choledocholithiasis have b een confirmed by sphincterotomy(n=5),common bile duct strictures were confirmed by surgical operation(n=11).Three other patients have delayed excretion of co ntract medium.Conclusion EUSGC allows a safe and accurate alternative method for obtaining cholangiography in those patients when ERCP or MRCP failed.